title: Early removal of nasogastric tube is beneficial for patients undergoing radical cystectomy with urinary diversion.
abstract: OBJECTIVE
  Examine the beneficial effect of early nasogastric tube (NGT) removal in patients undergoing radical cystectomy with urinary diversion.
  
  
  METHODS
  43 consecutive patients underwent radical cystectomy with urinary diversion and were randomized into 2 groups. In the intervention group (n = 22), the NGT was removed 12 hours after the operation. Comparatively, in the control group (n = 21), the NGT remained in place until the appearance of the first flatus. The appearance of ileus, patient ambulation, time to regular diet, and hospital discharge of the two patient groups were assessed. Patient discomfort due to the NGT was also recorded.
  
  
  RESULTS
  The 2 groups showed statistical homogeneity of their baseline characteristics. Two patients (9.09%) from the intervention and 3 patients (14.3%) from the control group developed postoperative ileus and were treated conservatively. No significant differences in intraoperative, postoperative, bowel outcomes or other complications were found between the two groups. All patients preferred the NGT to be removed first in comparison to their other co-existing drains.
  
  
  CONCLUSIONS
  This is the first randomized, prospective study, to our knowledge, to assess early NGT removal after radical cystectomy. We advocate early removal, independently of the selected type of urinary diversion, since it is not correlated with ileus and is advantageous in terms of patient comfort and earlier ambulation.
authors.affiliation: 1st Department of Urology, Athens University Medical School, LAIKO Hospital, Athens, Greece.
authors.forename: Ioannis
authors.initials: I
authors.lastname: Adamakis
authors.forename: Stavros I
authors.initials: SI
authors.lastname: Tyritzis
authors.forename: George
authors.initials: G
authors.lastname: Koutalellis
authors.forename: Theodoros
authors.initials: T
authors.lastname: Tokas
authors.forename: Konstantinos G
authors.initials: KG
authors.lastname: Stravodimos
authors.forename: Dionysios
authors.initials: D
authors.lastname: Mitropoulos
authors.forename: Constantinos A
authors.initials: CA
authors.lastname: Constantinides
mesh_terms: D000368:Aged; D016022:Case-Control Studies; D015653:Cystectomy; D020878:Device Removal / Q000379:methods*; D005260:Female; D006801:Humans; D045823:Ileus / Q000517:prevention & control; D007441:Intubation, Gastrointestinal; D008297:Male; D008875:Middle Aged; D011182:Postoperative Care / Q000379:methods; D011183:Postoperative Complications / Q000517:prevention & control; D013997:Time Factors; D016896:Treatment Outcome; D014547:Urinary Diversion